Outpatient therapy with ceftriaxone and oral cefixime for selected febrile children with sickle cell disease
| Autor: | Winfred C. Wang, Sylvia Harris, Sara W. Day, Rhonda Dancy, Judith A. Wilimas, Laura L. Williams |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Fever medicine.drug_class Antibiotics Administration Oral Bacteremia Anemia Sickle Cell Cefotaxime Sepsis Anti-Infective Agents Cefixime Internal medicine Outpatients medicine Humans Child business.industry Ceftriaxone Infant Hematology Bacterial Infections medicine.disease Sickle cell anemia Surgery Cephalosporins Hemoglobinopathy Oncology Child Preschool Pediatrics Perinatology and Child Health Patient Compliance Drug Therapy Combination Female Complication business medicine.drug |
| Zdroj: | Journal of pediatric hematology/oncology. 18(3) |
| ISSN: | 1077-4114 |
| Popis: | PURPOSE Children with sickle cell disease are at increased risk for bacterial sepsis and, when febrile, are usually hospitalized for intravenous antibiotic therapy pending results of blood cultures. In this study, we prospectively identified a group of febrile patients with sickle cell disease who were at low risk for sepsis and treated them with outpatient therapy. PATIENTS AND METHODS Children identified as low risk for sepsis were treated with an initial dose of intravenous ceftriaxone, followed by outpatient therapy with oral cefixime, and were monitored for 14 days after the initial visit. Compliance was assessed by phone calls to parents and by analysis of urine samples. RESULTS In 107 eligible febrile episodes (80 patients) over a 21-month period, no patient developed sepsis. One child developed bacteremia 3 days after completing the course of cefixime, and one had splenic sequestration on the fourth study day. Both patients did well. Side effects of cefixime were modest, and overall compliance was excellent (approximately 95%), although urine samples were returned by only 56% of parents. CONCLUSION We conclude that outpatient therapy is safe and effective in febrile patients with sickle cell disease who meet the criteria for a low risk of sepsis. |
| Databáze: | OpenAIRE |
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